基于儿童保健门诊的强化式情境教学模式在语言发育迟缓干预中的应用  

Application of the enhanced milieu teaching model in language intervention of children with language developmental delay in outpatient child healthcare clinic

作　　者：唐丽娜 颜田 徐璐[1] 郝燕[1] Tang Lina;Yan Tian;Xu Lu;Hao Yan(Division of Child Healthcare,Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院儿科学系儿童保健科,武汉430030

出　　处：《中华儿科杂志》2021年第11期916-921,共6页Chinese Journal of Pediatrics

摘　　要：目的探讨基于儿童保健门诊的强化式情境教学(EMT)模式在儿童语言发育迟缓早期干预中的作用。方法采用病例对照的研究设计,以2019年6月至2020年6月华中科技大学同济医学院附属同济医院儿童保健科就诊的28例2.5~4.0岁的语言发育迟缓患儿为研究对象作为干预组,应用EMT模式开展为期3个月(共12次)的一对一语言康复训练;选取同一时期在儿童保健门诊诊断为语言发育迟缓,但拒绝接受EMT或其他语言干预的患儿27例为对照组,两组患儿均在初诊3个月后进行随访评估。训练前后采用Gesell发育量表(GDS)和普通话听力理解和表达能力标准化评估(DREAM-C)对患儿初诊和复诊时的发育水平进行全面评价和对比研究,运用t检验评估干预效果。结果干预组患儿(男22例、女6例)训练后3个月复诊时GDS的语言能发育商显著高于初诊(64±21比52±17,t=4.960,P<0.01);DREAM-C的总体语言、听力理解、语义和句法均显著提高(89±16比77±14,90±16比77±15,93±20比79±19,84±14比76±11,t=5.061、5.301、5.058、3.209,均P<0.01)。对照组患儿(男19例、女8例)在3个月复诊时仅Dream-C标准化语言评估的语义这一项明显提高(82±26比71±18,t=2.330,P<0.05),GDS各个能区与初诊时差异均无统计学意义(均P>0.05)。结论以EMT模式的早期语言康复训练对语言发育迟缓患儿的各个语言能区有显著疗效,是一种较为适合儿童保健门诊环境的语言干预模式。Objective To explore the role of the enhanced milieu teaching(EMT)model in early intervention of children with language developmental delay(LDD)in outpatient child healthcare clinic.Methods Case-control study design was adopted.Twenty-eight children aged 2.5 to 4.0 years who were diagnosed with LDD from June 2019 to June 2020 at the Division of Child Healthcare,Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were recruited as the intervention group,and participated in one-on-one EMT model language rehabilitation sessions for 3 months(12 sessions).Another 27 children with LDD who attended the Division of Child Healthcare around the same period of time were recruited as control group,all of whom did not attend any types of language intervention in the subsequent three months.Both groups were followed up three months later.Gesell developmental scale(GDS)and diagnostic receptive and expressive assessment of Mandarin-comprehensive(DREAM-C)standardized language test were used to evaluate and compare children′s development level at the first and follow-up visit,with the treatment effect of the EMT model being evaluated with independent sample t-test.Results The language development quotient of GDS of the intervention group(22 boys and 6 girls)at the follow-up visit was significantly higher than that of at the first visit(64±21 vs.52±17,t=4.960,P<0.01).The Dream-C test scores of total language(89±16 vs.77±14,t=5.061,P<0.01),receptive language(90±16 vs.77±15,t=5.301,P<0.01),semantics(93±20 vs.79±19,t=5.06,P<0.01),and syntax after training(84±14 vs.76±11,t=3.209,P<0.01)were significantly higher than those at the first visit.In the control group(19 boys and 8 girls),the only improvement was found in the Dream-C semantics score(82±26 vs.71±18,t=2.330,P<0.05).There was no significant difference in any domains in GDS at the first and follow-up visit(all P>0.05).Conclusions Early language rehabilitation training based on the EMT model has a significant

关 键 词：语言障碍 环境疗法 语言疗法 

分 类 号：R493[医药卫生—康复医学] R749.94[医药卫生—临床医学]